title: Concordance and reproducibility between M-mode, tissue Doppler imaging, and two-dimensional strain imaging in the assessment of mitral annular displacement and velocity in patients with various heart conditions.
abstract: OBJECTIVE
  Mitral annular (MA) displacement reflects longitudinal left ventricular (LV) deformation and systolic velocity measurements reflect the rate of contraction; both are valuable in the diagnosis and prognosis of cardiac disease. The aim of this study was to test the agreement and reproducibility between motion mode (M-mode), colour tissue Doppler imaging (TDI), and two-dimensional strain imaging (2DSI) when measuring MA displacement and systolic velocity.
  
  
  RESULTS
  Using GE Healthcare Vivid 7 and E9 and Echopac BT11 software, MA displacement and velocity measurements by 2DSI, TDI, and M-mode determined in the septal and lateral walls in the apical four-chamber view were assessed in 50 control subjects and in 168 patients with various cardiac anomalies known to affect longitudinal displacement such as heart failure, mitral regurgitation, LV hypertrophy, and LV dilation. Intra- and inter-observer variability were tested using the Bland-Altman method in 125 patients. A relatively low bias between M-mode and TDI with respect to MA displacement (mean difference ± 1.96 standard deviation: 0.08 ± 0.35 cm) and a low bias between TDI and 2DSI with respect to MA peak systolic velocity (-0.13 ± 1.87 cm/s) were found. Reproducibility was acceptable for all methods with TDI having the lowest intra- and inter-observer variability.
  
  
  CONCLUSIONS
  LV function could be assessed in terms of MA displacement and systolic velocity using M-mode, TDI, and 2DSI. None of the measurement techniques are, however, interchangeable. Overall, TDI seems to be the most robust method, having the lowest observer variability.
authors.affiliation: Department of Cardiology, Faculty of Health Sciences, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, Copenhagen DK-2900, Denmark.
authors.forename: Martina Chantal
authors.initials: MC
authors.lastname: de Knegt
authors.forename: Tor
authors.initials: T
authors.lastname: Biering-Sorensen
authors.forename: Peter
authors.initials: P
authors.lastname: Sogaard
authors.forename: Jacob
authors.initials: J
authors.lastname: Sivertsen
authors.forename: Jan Skov
authors.initials: JS
authors.lastname: Jensen
authors.forename: Rasmus
authors.initials: R
authors.lastname: Mogelvang
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012984:Software; D013599:Systole
keywords: M-mode; mitral annular displacement; systolic tissue velocity; tissue Doppler imaging; two-dimensional strain imaging